Chronic Venous Insufficiency

What is Chronic Venous Insufficiency?

Chronic Venous Insufficiency [CVI] is a serious medical condition that is the result of venous reflux or backward flow of blood in the veins that leads to venous hypertension, inflammation and tissue damage. The condition is a vicious cycle that often starts with the failure of valves in the veins. The valves in a normal vein work to keep the blood flowing toward the heart even between muscle contractions. However, if the vein valves fail, they allow the blood to flow backwards away from the heart or toward the feet when you are standing.

The effect of venous backward flow or reflux is that blood in the veins pools in the legs. This leads to increased pressure in the veins: Venous Hypertension. The venous hypertension affects the local circulation in the leg which leads to local tissue acidosis and inflammation. The inflammation occurs along the vein wall with mononuclear white blood cells adhering to the walls of the vein. The white blood cells, which are part of the inflammatory process on the vein wall, release proteinases that lead to weakening and degradation of more valves and vein walls. It becomes a vicious cycle. [1]

How common is venous insufficiency?

Chronic Peripheral Venous Reflux Disease and Chronic Venous Insufficiency are very common. More than 25 million people in United States have venous reflux disease. These are health problems that are two times more common than heart disease. Venous reflux disease is five times more prevalent than peripheral arterial disease (PAD). [2]

prevalence and etiology of venous insufficiency

Chronic Venous Insufficiency Symptoms

Chronic Venous Insufficiency can cause symptoms such as heaviness, tiredness, and cramping in the legs. It can also cause burning or itching of the skin. CVI is the most common cause of leg or ankle swelling.

Skin changes such as dermatitis and hardening of the skin called lipodermatosclerosis is seen in up to a third of patients with CVI. Chronic Venous Insufficiency increases the risk of blood clots and can lead to leg ulcers.

It is a chronic progressive disease with up to 4% of sufferers progressing to a more advanced stage every year. [3]

Spectrum of chronic venous disease

Chronic Venous Insufficiency – More Than a Just a Cosmetic Concern

Chronic Venous Insufficiency is much more than some unappealing changes to skin on the legs. If untreated, Chronic Venous Insufficiency [CVI] can become a chronic disabling disease.
The impact of CVI on quality of life is similar to Congestive Heart Failure [CHF], Chronic Obstructive Pulmonary Disease [COPD] and other serious medical diseases. [4]

venous leg ulcers superficial thrombophlebitis

Chronic Venous Insufficiency and more serious complications
Patients with varicose veins or Chronic Venous Insufficiency are over 18 times more likely to develop Superficial Thrombophlebitis [SVT]. In fact, varicose veins are the most common risk factor for Superficial Thrombophlebitis. [5 and 6]

Superficial Thrombophlebitis, which is a risk of varicose veins or Chronic Venous Insufficiency, is associated with a 25% rate of simultaneous Deep Vein Thrombosis [DVT] and a 2% rate of Pulmonary Embolism [PE]. [7]

Bleeding of spider veins or varicose veins can be a very serious complication of Chronic Venous Insufficiency. There is a very small chance, less than 1%, of death from bleeding varicose veins. [8]

Finally, leg ulcers are a consequence of chronic venous insufficiency. Venous leg ulcers develop in 5% of patients suffering with chronic venous insufficiency. Over half a million people in the USA every year develop a venous leg ulcer. [9]

Up to 10% of patients with venous leg ulcers become permanently disabled by them. Over a billion dollars is spent on outpatient treatment of venous leg ulcers every year. [10]
This cost and suffering from Chronic Venous Insufficiency is very unfortunate. There are very effective treatments for varicose veins and chronic venous insufficiency that can prevent much of the suffering from CVI. [See column treatment of vein disease]

Prompt varicose veins treatment and Chronic Venous Insufficiency treatment can prevent venous leg ulcers and lessen the risk of bleeding and other serious complications. If you are looking for a doctor to perform your venous insufficiency treatment, call the Laser Lipo and Vein Center today! We will help get you through this difficult time.


Works Cited

  1. Chronic Venous Disease, JJ Bergan, n englj med 2006; 355:488-498 https://www.nejm.org/doi/full/10.1056/NEJMra055289
  2. American Heart Association. Contemporary Reviews in Cardiovascular Medicine: Chronic Venous Insufficiency Eberhardt, RT Circulation. 2005; 111:2398-2409 https://circ.ahajournals.org/content/111/18/2398.full
  3. Pannier, F., Rabe, E. Relevance of the Natural History of Varicose Veins and Refunded Care. Phlebology, 27(1)2012 23-26 https://phl.sagepub.com/content/27/suppl_1/23.
  4. Andreozzi, G.M., Quality of Life in Chronic Venous Insufficiency, Internation Angiology, Vol 24(3)2005 272-7.
  5. Guex, J.J., Thrombotic Complications of Varicose Veins. Dermatol Surg 1996; 22:378-382. https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.1996.tb00336.x/abstract
  6. Marchiori, A. Superficial Vein Thrombosis: Risk Factors, Diagnosis and Treatment, Semin Thromb Hemost 2006; 32:737-743. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180510/
  7. Decouus, H. Superficial Venous Thrombosis and Venous Thromboembolism. Ann Intern Med.2010; 152:218-224. https://annals.org/article.aspx?articleid=745598
  8. Byard RW, Gilbert JD. The incidence and characteristic features of fatal hemorrhage due to ruptured varicose veins. A 10 year autopsy study. Am JForensic Med Pathol 2007; 28:299-302.
  9. O’Donnell TF, Passman M. J Vasc Surg 2014; 60:1S-90S
  10. MA H, et al. J Vasc Surg 2014; 2(4):355-61.